Objective: Clarifying the discrepancy between frequently high oxalate concentrations present in saliva, but negligible amounts of calcium oxalate deposits found on oral surfaces.
Methods: Studying the calcium oxalate concentration range that can lead to heterogeneous crystallization in the oral cavity. a) Minimum: calcium oxalate monohydrate (COM) seed crystals were pre-grown ([Ca2+] = [C2O42-] = 1 mM, 30 min, 37 °C), and then re-immersed for ≥6 h to find the solubility equilibrium concentration (no growth, no dissolution). The concentrations tested were [Ca2+]/[C2O42-] : 0.055/0.050, 0.060/0.055, 0.070/0.065 and 0.080/0.075 mM. Supersaturations were calculated via the Debye-Hückel-theory and COM morphologies examined by scanning electron microscopy (SEM). b) Maximum (at the heterogeneous/homogeneous crystallization equilibrium): hydroxyapatite (HA) seed crystals were used to heterogeneously crystallize COM (37 °C, 24 h), using oxalate concentrations between 0.2 and 0.5 mM and calcium concentrations of 0.5 mM. COM-forming oxalate consumption was spectroscopically examined; COM precipitates were investigated by SEM; and HA identity was confirmed by X-ray analysis.
Results: Within the concentration range of [Ca2+]/[C2O42-]:0.060/0.055 mM (minimum) and [Ca2+]/[C2O42-]:0.50/0.25 mM (maximum) COM precipitates heterogeneously. In terms of mass, this corresponds to a range of 8.04-36.53 mg/l (daily) or an average of 14.32 mg COM (mimicking e.g. plaque mineralization). Higher concentrations react homogeneously (mimicking precipitation within saliva).
Conclusion: In vivo, only ∼0.05 % oxalate present in saliva reacts with oral surfaces daily, corresponding to ∼0.0665 μmol/l or ∼9.72 μg COM per day. Calcium-consuming calcium phosphate formation and phosphoproteins such as statherin obviously hinder intraoral COM formation.
Keywords: Calcium oxalate; Calcium phosphate; Drug delivery; Oral surface reactions; Salivary proteins; Tartar formation.
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